Estrogens, Total

Laboratory assay overview

All steroids requiring the action of 17-Hydroxylase enzyme are low, including 17-OH Progesterone and Cortisol. Levels of estradiol and aldosterone are also low. Additional testing may be required to establish a diagnosis.

Laboratory assay overview

This panel measures the concentrations of estrone and estradiol, the 2 most potent estrogens that are biologically active. This panel may help assess estrogen status in children and nonpregnant adults. Estrogens are endogenous steroids that regulate growth and maintenance of sex organs and secondary sex characteristics in women. Estrogens also have other functions and effects, such as production of liver proteins, arterial vasodilation, reduction of intraocular pressure, influence on mood, and maintenance of bone density in both males and females [1]; lack of estrogens has important consequences in both men and women. Low estrogen levels in normal men receiving a gonadotropin releasing hormone agonist and an aromatase inhibitor is associated with decreased sexual function and increased body fat [2]. Measurements of estrogens may help evaluate sexual maturity, menstrual abnormalities, fertility abnormalities, fetal-placental health in pregnancy, tumors that excrete estrogens, or feminization syndromes in men [3]. Increased levels of estrogens may be observed in normal pregnancy, precocious puberty, hyperthyroidism, liver cirrhosis, and ovarian, testicular, and adrenal tumors. Decreased levels of estrogens may be observed in failing pregnancy, Turner syndrome, hypopituitarism, primary and secondary hypogonadism, menopause, polycystic ovarian disease, and anorexia nervosa [4]. Estrone levels may exhibit diurnal rhythm in postmenopausal women because of the adrenal origin of the estrone precursor (androstenedione). Estradiol levels do not have the same diurnal variation [3]. The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings. References 1. Gruber CJ, et al. N Engl J Med. 2002;346(5):340-352. 2. Finkelstein JS, et al. N Engl J Med. 2013;369(11):1011-1022. 3.Nerenz RD, et al. Reproductive endocrinology and related disorders. In: Rifai N, et al. eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elservier Inc; 2022:9521-9714. 4. Pagana K, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed. Elsevier Inc; 2020:346-400.

Laboratory assay overview

Recommended for clinical situations in which increased sensitivity of E2 levels is appropriate, including postmenopausal women, men, and children and adolescents

Laboratory assay overview

Diagnostic applications of estradiol assays include assessment of ovarian function in a wide variety of situations (menstrual disorders, precocious or delayed puberty, assisted reproduction protocols). For men, estradiol measurement may be useful in the evaluation of gynecomastia.

Quest Diagnostics population reference ranges

Quest Diagnostics calculates these statistical intervals for this specific assay and demographic group, not as universal optimal targets.

Laboratory assay overview

This panel measures the concentrations of estrone, estradiol, and estriol, the 3 main types of estrogens in serum. This panel may be useful in assessing estrogen status. Estrogens are endogenous steroids that regulate growth and maintenance of sex organs and secondary sex characteristics in women. Estrogens also have effects on many other organ systems such as maintenance of bone density, production of liver proteins, arterial vasodilation, reduction of intraocular pressure, and influence on mood [1]. Measurements of estrogens may help evaluating sexual maturity, menstrual abnormalities, fertility abnormalities, fetal-placental health in pregnancy, tumors that excrete estrogens, and feminization syndromes in men [2]. Increased levels of estrogens may be observed in normal pregnancy, precocious puberty, hyperthyroidism, liver cirrhosis, and ovarian, testicular, and adrenal tumors. Decreased levels of estrogens may be observed in failing pregnancy, Turner syndrome, hypopituitarism, primary and secondary hypogonadism, menopause, Stein-Leventhal syndrome, and anorexia nervosa [3]. Estriol becomes the predominant estrogen only in late pregnancy. Measurements of estriol are commonly used to help screen for certain fetal abnormalities such as Down syndrome. In non-pregnant women and men, measurements of estriol have limited clinical use [2]. The results of this test should be interpreted in the context of pertinent clinical and family history and physical examination findings. References 1. Gruber CJ, et al. N Engl J Med. 2002;346(5):340-352. 2. Haymond S, et al. Reproductive related disorders. In: Burtis CA, et al. eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 4th ed. Elsevier Inc; 2006:2097-2152. 3. Pagana K, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed. Elsevier Inc; 2020:346-400.

Laboratory assay overview

Evaluate for ovarian estrogen producing tumor in the premenarcheal and postmenopausal female; evaluate estrogen excess in males. Estrogen analysis may be helpful in establishing time of ovulation and optimal time for conception. Serial samples must be collected over several days to evaluate baseline and peak total estrogen levels.

Laboratory assay overview

Estrogens are secreted by the gonads, adrenal glands, and placenta. Total estrogens provide an overall picture of estrogen status for men and women.

Quest Diagnostics population reference ranges

Quest Diagnostics calculates these statistical intervals for this specific assay and demographic group, not as universal optimal targets.

Laboratory assay overview

This panel is intended to aid physicians in diagnosing polycystic ovary syndrome (PCOS) by assessing biochemical hyperandrogenism and ruling out other disorders that mimic the clinical features of PCOS. This assay provides the sensitivity and specificity required for the assessment of the low testosterone levels found in women, children, adolescents, and hypogonadal men.1

Laboratory assay overview

ReproSURE™ is a blood test comprised of Anti-Müllerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and Estradiol designed to provide information about ovarian reserve. Ovarian reserve is a term used to describe a woman's reproductive potential, including the number of oocyttes (eggs) she possesses. 1. ReproSURE is a blood test comprised of AMH, FSH and Estradiol hormones designed to provide information about ovarian reserve. 2. While no laboratory test can predict pregnancy, these ovarian reserve tests assess oocyte quantity and help predict ovarian response to stimulation in order to individualize fertility options including assisted reproductive technology (ART) treatment. 3. Correct timing of blood collection is important. Serum specimen for ReproSURE testing should be collected on day 3 of your menstrual cycle. Day 2 or 4 collection may also be acceptable. FSH and estradiol levels rise and fluctuate after cycle day 3. If FSH and estradiol levels are higher than expected, you may wish to verify the cycle day of the blood collection. 4. These tests are not the sole criteria used to determine appropriateness of ART or any other treatment. 5. These tests do not evaluate egg quality. Egg quality peaks in a woman's twenties and then declines with age. 6. Antral follicle count (AFC) is another measure of egg supply that can be obtained by ultrasound observation.